Case Report: Smudge Cells as a Valuable Prognostic Marker in Infectious Mononucleosis

Infectious mononucleosis is a very common infection. It is caused mostly by Epstein‒Barr virus (EBV), which belongs to herpesviridae or sometimes by the other member, Cytomegalovirus (CMV). It spreads through saliva. It has typical symptoms such as fever, extreme fatigue, sore throat and tonsillitis, enlarged lymph nodes in the neck, armpit, skin rashes, bodyache, and obstruction in the upper respiratory tract, and enlarged spleen and liver. It can lead to other complications such as anemia, encephalitis, meningitis, inflammation of the kidney, heart muscles, and rupture of the spleen. Laboratory diagnosis is costly. The physician may order heterophile antibody tests (monospot-test), EBV- or CMV- specific antibody tests, and viral DNA load. Patients with lower financial means do not want to go for such tests. This research indicates that a close examination of a blood sample for unusual lymphocytes and smudge cells (Downey cells) could also be the least expensive way to address this problem, although it is not a confirmatory test.